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LostWaves

LostWaves: Few questions about Risperidone

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LostWaves

Hi. Was taking 4 mg of risperidone for two months. Suddenly stopped taking it for a week (didn't notice any withdrawal). Then took 2 mg for two weeks (approved by psychiatrist). Then took 1 mg for two weeks (approved by psychiatrist). Have not noticed any withdrawal symptoms. Asked psychiatrist if it was okay for me to suddenly go from 4 mg to 2 mg, and then 2 mg to 1 mg. She said it was okay since I hadn't been showing any symptoms. I have read that withdrawal symptoms can surface after months or even a year after you stop taking it. I am not sure what that person's credibility was. I have also read, from a .org website that the withdrawal symptoms are mild and rare.

I have stopped taking the 1 mg for almost a week, and I am wondering if I will be alright. I have not noticed any withdrawal symptoms, and I feel like I will still be seeing my psychiatrist for a little while at least. I am also wondering if it is true that withdrawal symptoms can surface months or even a year after you stop taking the medication. That just seems far-fetched to me.

 

Any help is appreciated!

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Shep

Hi, LostWaves.

 

Welcome to Surviving Antidepressants.

 

Yes, it is possible to have a delayed withdrawal with these drugs. It only takes a month to develop a dependency on an antipsychotic. So it's possible you are dependent after 2 months, but with dependency, there's no way of knowing who is or isn't dependent. 

 

Here is some information that may be helpful. 

 

Tips for tapering off Risperdal (risperidone)

 

Why taper by 10% of my dosage?

 

How psychiatric drugs remodel your brain - NOTE: this is on antidepressants, but antipsychotics also remodel the brain in relation to dopamine. 

 

Did you go on this drug for what is termed a "psychotic" symptom (i.e. hearing voices, seeing visions, being in an altered state)? If so, it's important to taper so you don't have any rebound symptoms. The reason you went on the drug is important in us helping you make the decision to reinstate or not and to provide more specific non-drug coping information. 

 

It's possible you could reinstate a small amount and do a more rapid taper than 10% due to only being on the drug for 2 months. If you do consider reinstatement, here is some information:

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

If you decide not to reinstate, it's important to develop some non-drug coping skills in case symptoms arise. There could be a delay, so it's important to learn how to handle these symptoms so you don't get caught back up in the system. 

 

Non-drug techniques to cope with emotional symptoms

 

Please keep in mind that there is a windows and waves recovery from these drugs:

 

The Windows and Waves Pattern of Stabilization

 

What is withdrawal syndrome? 
 

Coming off an antipsychotic can get difficult if insomnia becomes a problem because that can make rebound symptoms more likely. Also, have you been off and on antipsychotics or other psych drugs before? That can also play a role in how you'll do. Are you on any other drugs or supplements? 

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

  • Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • This is a direct link to your signature:  Account Settings – Create or Edit a signature.

 

Please use this thread to ask questions and let us know how you're feeling. 

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LostWaves

Hi Shep. Thanks for the reply. I updated my signature. I went on this drug because I told people that I heard a voice in my head. I read in a book that there was scientific evidence for telepathy, and I thought I could talk to my friends in my head (or verbally), like it was a Skype call. At some point, I realized I wasn't communicating with my friends telepathically. And since then, I haven't had trouble with 'voices.'

If I were to reinstate, how would you recommend I do it? I was already on 1 mg for two weeks. Would you want me to take it down to .5 or .25 mg? And for how long? Is it safe to cut risperidone pills?

 

Currently, I plan on staying off risperidone. I believe I am going to keep seeing my psychiatrist for the next five months, and will have ready access to 1 mg of risperidone, throughout that time, if anything comes up. I am wondering what the odds are, that I will experience delayed withdrawal symptoms, even after the five months have passed.

 

Edited by ChessieCat
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Shep
16 hours ago, LostWaves said:

If I were to reinstate, how would you recommend I do it? I was already on 1 mg for two weeks. Would you want me to take it down to .5 or .25 mg? And for how long? Is it safe to cut risperidone pills?

 

Hi, LostWaves. Thanks for the additional information.

 

Yes, you can cut the pills. Please see:

 

Tips for tapering off Risperdal (risperidone)

 

The farther out you are from when you took your last dose, the less medication you should reinstate. It's only been 11 days, so you could return to your 1 mg dose or maybe a lower dose at .75 mg since you're not having any symptoms so far. 

 

If you decide to ride it out a bit longer and wait to reinstate, you would start at an even lower dose. The first post in the reinstatement thread explains why. 

 

16 hours ago, LostWaves said:

Currently, I plan on staying off risperidone. I believe I am going to keep seeing my psychiatrist for the next five months, and will have ready access to 1 mg of risperidone, throughout that time, if anything comes up. I am wondering what the odds are, that I will experience delayed withdrawal symptoms, even after the five months have passed.

 

 

You really need to weigh the effects of delayed withdrawal with your ability to self manage and cope. If you experience hearing voices again, do you know how to cope? You may want to read over information on some alternatives and see if you can find a therapist who does Open Dialogue or other similar treatments in lieu of medication. That kind of treatment is by far more effective. 

 

Open Dialogue: Alternative Care for Psychosis

 

Alternatives for psychotic outbreaks

 

You may also find the website Mad in America helpful, as it has articles and blogs about non-drug treatments, as well as information on the dangers of these drugs.

 

Mad in America

 

And they have great podcasts:

 

Mad in America podcasts

 

And a great list of non-drug coping skills in case you do get withdrawal symptoms, which could include other symptoms besides the reason you started taking the drug in the first place. Some people find they experience insomnia and anxiety when they come off an antipsychotic, so there are some great resources for mindfulness, CBT, yoga, etc which may help: 

 

Non-drug techniques to cope with emotional symptoms

 

How are you feeling as far as motivation goes? How is your sleep? 

 

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LostWaves

Shep, thank you again for the response. I am confident that I will not hear 'voices' again. My hearing of the voices, was contingent upon me believing that I had telepathic capabilities. Since I no longer have this belief, I strongly believe that I don't have anything to worry about. If for some reason I do hear voices again, I will meditate.

I am more concerned about developing withdrawal symptoms, that I did not have before. I had a mild headache last night, but I think it is gone now. My sleep is fine. I have felt unmotivated recently, but I believe that is more due to my life circumstances (having trouble deciding on a career path). I also felt this lack of motivation was present, even while I was on 1 mg of risperidone. Also, I have been able to go to the gym, as well as work, even while dealing with motivation issues.

 

I also have a therapist (different from my psychiatrist) who has known me before any of this started, and who I see every two weeks. I am going to see him soon. I can talk to him about any unpleasant emotions I have, but lately, I haven't felt the need to.

Right now my plan is, to taper from .75 mg for two weeks, then .5 mg for two weeks, then .25 mg for two weeks; if I reinstate between the 14 to 21 day period (of discontinuation). Or, I would taper from .5 mg for two weeks, then .25 mg for two weeks, if I reinstate between the 21 to 28 day period (of discontinuation).

Does this seem reasonable to you?

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Shep

This is a hard call, LW. The fact that you've solved your problem with the voices is great, as rebound psychosis is the main concern when people come off an antipsychotic. 

 

So reinstating at this point, especially when you don't have any withdrawal symptoms, may not be warranted with only 2 months' use. While it is possible to become dependent in that time, the fact that you're sleeping 11 days off is also a good sign. 

 

Also, you have a nice support system set up with people you can reach out to should you start to feel unwell. 

 

I'm going to ask the other mods for feedback. 

 

Two other questions that will help us help you sort this out: 

 

1. In your signature, you wrote that you took a very short round of Seroquel in April of 2016 - was that for the same issue as you had in December 2017? 

2. Did you have any withdrawal symptoms from going cold turkey from 4 mg on February 6 that led to you reinstating 2 mg on February 14? 

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LostWaves

Shep, thanks again for the continued feedback.

 

1. The seroquel was for depression. I stopped taking it, only because the doctor asked me how it made me feel. I said that I did not like it, and he said that I did not have to take any medication after that.

 

2. No. I simply reinstated because I wanted to taper. I did not want to develop withdrawal symptoms.

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Shep

Thanks for your response, LW. I'm not comfortable with any psychiatrist who prescribes an antipsychotic for depression so I'm glad you came off that one so quickly. I'm glad you have a separate therapist to talk to, as there are so many options for handling depression without medication (and certainly not an antipsychotic!). 

 

Let's see what other mods have to say because at this point, I'm wondering if reinstating is really wise with such short term use and no withdrawal symptoms after a rapid taper. With a month or so of use, you can get away with a much more rapid taper, so you're in a bit of a gray area, but not by much. 

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Shep

Hi, LW. How are you doing? 

 

I talked to another mod about your case and we think it best for you to not reinstate at this time. If you continue to sleep well, are able to work on non-drug techniques for any withdrawal symptoms that might pop up AND for your pre-existing depression (if you are still having problems with that), you may do very well without reinstating. 

 

There is a risk to both reinstating and not reinstating. The risk in not reinstating is you may have some withdrawal symptoms later on, as we've discussed. However, there's a risk in reinstating because if you aren't already dependent (and there's no way of knowing ahead of time), you may develop dependency or a greater dependency by staying on the drug longer. 

 

What do you think about not reinstating and giving yourself a lot of self care, working with meditation, gentle yoga, a healthy diet, etc. over the coming weeks and see how you do? 

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LostWaves

Hi Shep. I'm doing decent, how are you?

Thank you again for the feedback. I greatly appreciate it. I am fine with not reinstating. I do not know how to do yoga, and I believe I am relatively healthy with my diet choices as it is (but you are welcome to offer suggestions). I will continue to meditate. Considering the fact that I was only on the drug for two months (three months, if you count the tapering), is there any way of knowing when I would be most likely to experience any withdrawal symptoms?

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Shep

Hi, LostWaves. Sorry, we cannot predict withdrawal, but the best advice I can give you is to live life fully but gently. Explore new things but don't stress out your nervous system. 

 

Meditation is awesome and highly recommended, so you have a great non-drug coping skill already. 

 

As far as diets go, you may want to limit sugar and caffeine for the next few weeks. These can be very stimulating. Try to have clean, organic (when possible) meats and veggies and fruits. Make sure you're eating regularly throughout the day, as some people in withdrawal experience drops in blood sugar. Low blood sugar drops can mimic withdrawal with anxiety, dizziness, weakness, depression, etc. So it's important to fuel the body. 

 

And try to keep a regular routine as far as bedtime goes. Basically, the more stability and routine you can have, the less bumps to the nervous system. 

 

Please post from time to time and let us know how you're doing. The main reason we have so little advice for short time users is we've had very few short time users who show up on this website. Very well done for researching your drugs and getting this information early on. :)

 

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